Individual
JACK CARTER SYKSTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
1900 MOUNT VERNON AVE, ALEXANDRIA, VA 22301-1302
(202) 960-4193
Mailing address
817 L ST NE, WASHINGTON, DC 20002-3640
(256) 690-8024
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0717001799
VA
Other
Enumeration date
03/10/2021
Last updated
03/10/2021
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